Abstract 15159: Association Between Duration of Resuscitation and Favorable Outcome After Out-of-Hospital Cardiac Arrest: Implications for Prolonging Resuscitation
Bibliographic record
Abstract
Introduction: Little evidence guides the duration of resuscitation (CPR-DUR) in OHCA. We estimated the impact of CPR-DUR on the probability of favorable neurologic outcome at hospital discharge (mRS 0-3) in OHCA using a large, multi-center cohort. Hypothesis: CPR-DUR is associated with mRS 0-3, and this association is modified by case features. Methods: Secondary analysis of multi-center clinical trial (ROC-PRIMED) of adult, atraumatic, EMS-treated, OHCA. Primary exposure was CPR-DUR (professional CPR to ROSC or termination). Primary outcome was mRS 0-3. Subjects were also classified as survival with poor outcome (mRS 4-5), ROSC without survival (mRS 6), or no ROSC. We plotted subject accrual as a function of CPR-DUR, and estimated dynamic probabilities of mRS 0-3 for the whole cohort and subject phenotypes (shockable rhythm [VF/VT], witnessed [WIT], bystander CPR [bCPR]). Adjusted logistic regression models tested associations between CPR-DUR and mRS 0-3 with interaction terms for VF/VT, WIT, and bCPR. Results: Primary cohort was 11,368 subjects (69 [IQR: 56-81] years; 63% male; 47% WIT; 38% bCPR; 22% VF/VT; 85% advanced airway; 14% induced hypothermia; 31% cardiac catheterization). Of these, 4,023 (35.4%) had ROSC, 1,232 (10.8%) survived to discharge, and 905 (8.0%) had mRS 0-3. Distribution of CPR-DUR differed by outcome (p Conclusions: CPR-DUR was associated with mRS 0-3 at hospital discharge. Subjects with favorable phenotypes had resilience to prolonged resuscitation, warranting either continued efforts or early consideration of novel therapies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".